目的 探讨肌少症性肥胖（SO）诊断标准的演进及其在中国老年人群中的本土化综合干预路径。方法 评述ESPEN/EASO最新共识，结合我国老年人代谢特征，系统分析“筛查-诊断-分期”流程及运动营养协同干预的临床效能。结果 SO诊断核心在于识别“隐性肥胖”，建议在AWGS2019标准基础上，叠加中国特异性腰围切点（男≥90 cm，女≥85 cm）或体脂率指标，并应用ALM/BMI校正肌肉质量。研究证实，以渐进式抗阻训练联合高蛋白营养（1.2~1.5 g·kg-1·d-1）为核心的协同模式，通过激活mTOR通路可显著逆转肌肉流失并改善胰岛素抵抗。融入八段锦等传统功法及乳清蛋白补充，能有效重塑中国患者“高碳水、低蛋白”的膳食习惯，提升依从性。结论 构建护士主导、社区依托的多学科管理模式，并借助远程健康工具实现闭环监测，是提升我国SO精准诊疗水平的关键路径。

      Objective To explore the evolution of diagnostic criteria for sarcopenic obesity（SO）and its localized comprehensive intervention pathways tailored to the metabolic characteristics of the Chinese elderly population．Methods The latest ESPEN/EASO consensus was reviewed．Combined with the metabolic profile of Chinese older adults，the “screening-diagnosis-staging” workflow and the clinical efficacy of synergistic exercise and nutrition interventions were systematically analyzed．Results The core of SO diagnosis lies in identifying “hidden obesity．”It is recommended to incorporate Chinese-specific waist circumference cut-offs（male≥90 cm，female≥85 cm）or body fat percentage into the AWGS2019 framework，utilizing ALM/BMI for muscle mass calibration．Evidence suggests that a synergistic model，centered on progressive resistance training（PRT）and high-protein nutrition（1.2~1.5 g·kg-1·d-1），can significantly reverse muscle loss and improve insulin resistance by activating the mTOR pathway．Integrating traditional Chinese exercises（e. g. ，Baduanjin）and whey protein supplementation effectively reshapes the “high-carbohydrate，low-protein” dietary habits of Chinese patients，thereby enhancing intervention adherence．Conclusions Establishing a nurse-led，community-based multidisciplinary management model，integrated with digital health tools for closed-loop monitoring，is a pivotal strategy for enhancing the precision of SO diagnosis and treatment in China．